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Combivir卡贝茲-药品介绍：
Combivir是一种含有Epivir(R) (lamivudine, 3TC)和Retrovir(R) (zidovudine, AZT)的复方药物。
Combivir与其他抗逆转录病毒药物结合使用，治疗HIV感染。乳酸血症和带有脂肪变性的严重胃下垂已有报告。Zidovudine引起血液毒性，包括嗜中性白血球低下和严重贫血，尤其在晚期HIV疾病中，长期服用後出现症状性肌病变。感染乙型肝炎和HIV并且中止lamivudine（它是Combivir的一种成份）的患者出现乙型肝炎严重急剧恶化。对于中止Combivir并且感染HIV和乙型肝炎的患者，应对其进行至少几个月的临床和试验室肝功能监视。在适当情况下，还可开始进行乙型肝炎治疗。接受抗逆转录病毒药物治疗的患者出现过身体脂肪重新分布和积累的情况。这些事件的因果关系、机制和长期後果目前尚不为人所知。最常见的副作用是头痛（35%）、恶心（33%）、不适/疲劳（27%）以及鼻腔症状（20%）。
HIV药物不能治愈HIV感染/AIDS或防止HIV传给他人。
药理作用：
含两种核苷类逆转录酶抑制剂，其临床效果优于单一用药。两者应用有协同作用，均是HIV逆转录酶的竞争抑制剂，主要抗病毒活性通过单磷酸形式渗入病毒的DNA链中，导致病毒DNA链不能合成。
适应证：
适用于HIV感染(成人及12岁以上儿童)，有进行性免疫缺陷(CD4＜500/u1)者。能明显降低疾病进展的危险性和死亡率。
禁忌证：
①禁用于对其任何成分在临床上过敏的患者。②禁用于中性粒细胞＜0.75×109/L或血红蛋白＜75g/L的病人。
药物剂型：
口服白膜片，每片含300mg Zidovudine和150mg Lamivudine。
用法用量：
推荐剂量每次l片，每天2次。可与或不与食物同服。如需调整某一种药物的用量时应分开服用。肾功能不全时调整剂量。必要时应分开服用，以便于调整剂量。
注意事项：
1、血液学变化：可以发生严重的贫血或骨髓抑制。当血红蛋白低于90g/L需要调整剂量，建议用药最初3个月最少每两周查一次血常规，以后每月查一次。
2、妊娠最初3个月禁止服用该药。建议中断哺乳。
3、肝功能异常及酸中毒，若转氨酶水平迅速增高，进行性肝大或明显乳酸酸中毒，应停止服药。
4、其他常见副作用，两者合用与分别用任何一种的注意事项相同。
Combivir (zidovudine + lamivudine)
What is Combivir?
Combivir is an HIV medication. It is in a category of HIV medicines called nucleoside reverse transcriptase inhibitors (NRTIs). Combivir prevents HIV from altering the genetic material of healthy CD4 cells. This prevents the cells from producing new virus and decreases the amount of virus in the body.
Combivir is marketed by ViiV Healthcare. It was approved by the U.S. Food and Drug Administration (FDA) for use by people living with HIV in 1997.
Combivir is a combination of two drugs: 300mg of Retrovir (zidovudine) and 150mg of Epivir (lamivudine). Combivir should be prescribed by a healthcare provider for patients who need both of these drugs. Both of these drugs can still be purchased individually for use in combination with other HIV drugs.
Combivir must be combined with at least one other HIV drug, usually a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI).
A patient assistance program (PAP) has been established for people living with HIV who do not have private or public health insurance and are unable to afford Combivir. To learn more about the PAP for Combivir, call 888-825-5249 or refer to the program's website for more information. For those with private health insurance, a program has been established to help cover each Combivir co-payment, up to $100 every month. To learn more about this co-pay program, check out mysupportcard.com.
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What is known about Combivir?
Combivir is taken twice daily, one tablet in the morning and one tablet in the evening, with or without food.
Combivir should not be any more or less effective than Retrovir and Epivir taken as separate pills together. However, it is considered to be a much more convenient way of taking these two anti-HIV drugs.
For HIV-positive adults beginning HIV drug therapy for the first time, Combivir is listed as an "alternative" NRTI option by the United States Department of Health and Human Services in its treatment guidelines. Tenofovir and emtricitabine, used together as Truvada or as a part of Atripla (efavirenz, tenofovir and emtricitabine), is listed as the "preferred" dual-NRTI option. For HIV-positive pregnant women, however, Combivir is listed as a "preferred" NRTI option, when combined with the protease inhibitor Kaletra (lopinavir/ritonavir). To learn more about these recommendations and options, click here.
See the "What is known about..." sections of Retrovir and Epivir for information about possible drug resistance.
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What about drug interactions?
Combivir should not be taken at the same time as Emtriva or Truvada (containing Viread and Emtriva). This is because the Epivir in Combivir is very similar to Emtriva, and it is not believed that combining these two HIV drugs will make a regimen any more effective against the virus. Similarly, Combivir should not be taken at the same time as Retrovir, Epivir, Epzicom (containing Ziagen and Epivir) or Trizivir (containing Ziagen, Epivir and Retrovir).
See the "What about drug interactions?" sections of Retrovir and Epivir.
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What about side effects?
Bone marrow problems, such as decreased production of red blood cells and/or white blood cells, can occur in people talking Retrovir, one of the two active drugs in Combivir. Contact your doctor immediately if you develop unusual fatigue, pale skin, sore throat, fever, or chills, which may be signs of bone marrow problems.
A rare but potentially serious side effect of Retrovir, one of the two drugs in Combivir, is myopathy (damage to the muscles, including the heart). People who use Retrovir for a long period of time, meaning several years, are at the greatest risk for myopathy. General symptoms of myopathy include weakness of limbs, usually proximal (located close to the center of the body).
Lactic acidosis, which can be fatal, and severe liver problems have been reported in people taking nucleoside reverse transcriptase inhibitors (NRTIs), including Retrovir and Epivir, the two active drugs in Combivir. Contact your doctor immediately if you experience nausea, vomiting, or unusual or unexpected stomach discomfort; weakness and tiredness; shortness of breath; weakness in the arms and legs; yellowing of the skin or eyes; or pain in the upper stomach area.
HIV drug regimens containing nucleoside reverse transcriptase inhibitors (NRTIs), including Combivir, can cause increased fat levels (cholesterol and triglycerides) in the blood, abnormal body-shape changes (lipodystrophy; including increased fat around the abdomen, breasts, and back of the neck, as well as decreased fat in the face, arms, and legs), and diabetes. These side effects of HIV drug therapy are reviewed in our lessons on Lipodystrophy, Facial Lipoatrophy, and Risks To Your Heart (Hyperlipidemia).
If you have hepatitis B and HIV and plan to stop taking Combivir, your doctor might want to frequently check your liver enzymes after stopping treatment. This is because the Epivir in Combivir is also active against the hepatitis B virus (HBV). If Epivir is stopped abruptly, it can cause liver disease to "flare" and damage the liver.
See the "What about side effects?" sections of Retrovir and Epivir for additional possible side effects.
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Can pregnant women take Combivir?
Combivir is classified by the FDA as a pregnancy category C drug. Pregnancy category C means that animal studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. HIV-positive women who become pregnant should discuss the benefits and possible side effects of HIV treatment to help protect their babies from HIV (see our lesson called Family Planning, Pregnancy & HIV).
It is not known whether Combivir passes into breast milk and what effect they may have on a nursing baby. To prevent transmission of the virus to uninfected babies, it is recommended that HIV-positive mothers not breast-feed.
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What should I tell my doctor before taking Combivir?
Before taking this medication, tell your doctor if you have: kidney disease; liver disease (including hepatitis B); or low blood cell counts (anemia or low white blood cells).
Tell your doctors and pharmacists about all medicines you take. This includes prescription medications, over-the-counter products, or herbal/natural remedies.
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Where can I learn more about clinical trials involving Combivir?
If you would like to find out if you are eligible for any clinical trials that include Combivir, there is an interactive web site run by ACRIA, the AIDS Community Research Initiative of America.
Another useful service for finding clinical trials is AIDSinfo.nih.gov, a site run by the US National Institutes of Health. They have "health information specialists" you can talk to at their toll-free number at 1-800-HIV-0440 (1-800-448-0440).
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原产地英文商品名:
COMBIVIR (150/300)mg/tab 60tabs/box
原产地英文药品名:
LAMIVUDINE/ZIDOVUDINE
中文参考商品译名:
卡贝茲 (150/300)毫克/片 60片/盒
中文参考药品译名:
拉米夫定/齐多夫定
生产厂家中文参考译名:
葛兰素史克
生产厂家英文名:
Glaxosmithkline
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